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General NPI Number Information
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NPI Number | 1629082052
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Entity Type | Organization
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Legal Business Name | RONALD M. GERECHT DDS & H. MICHAEL GOLDBERG DDS A PROFESSIONAL CORP
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2031 W ALAMEDA AVE SUITE 320
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City | BURBANK
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State | CA
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Zip | 91506-2958
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Country | US
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Telephone | 818-953-5401
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Fax | 818-953-2811
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Provider Business Mailing Address
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Address Line | 2031 W ALAMEDA AVE SUITE 320
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City | BURBANK
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State | CA
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Zip | 91506-2958
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Country | US
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Telephone | 818-953-5401
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Fax | 818-953-2811
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HERBERT MICHAEL GOLDBERG
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Credential | D.D.S.
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Telephone | 818-953-5401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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